间歇导尿法联合盆底肌康复训练在宫颈癌患者术后康复中的应用

郑芝; 邬真; 颜林志; 金小青; 赵宇; 梅慧红

doi:10.16766/j.cnki.issn.1674-4152.002966

间歇导尿法联合盆底肌康复训练在宫颈癌患者术后康复中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002966

郑芝^1, ,,
邬真¹,
颜林志¹,
金小青¹,
赵宇¹,
梅慧红²

1.
温州医科大学附属第二医院妇科，浙江温州 325000
2.
温州医科大学附属第一医院妇科，浙江温州 325000

基金项目:

浙江省医药卫生科技计划项目 2020KY643

温州市基础性医疗卫生科技项目 Y20210329

详细信息

通讯作者:
郑芝，E-mail：zheng1236985@163.com

中图分类号: R737.33 R473.71
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- 文章访问数: 148
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- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-20
- 网络出版日期: 2023-05-31

Effect of intermittent catheterization combined with pelvic floor muscle rehabilitation training on postoperative rehabilitation in patients with cervical cancer

1.
Department of Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨间歇导尿法联合盆底肌康复训练在宫颈癌患者术后康复中的应用，分析对患者膀胱功能、生活质量的影响，为宫颈癌术后康复方案的制定提供参考。方法选择2020年10月—2022年10月在温州医科大学附属第二医院接受手术治疗的宫颈癌患者94例作为研究对象，根据随机数表法分为试验组和对照组，每组各47例。对照组患者术后接受常规盆底康复措施，试验组患者术后接受间歇导尿法联合盆底肌康复训练。比较2组患者术后盆底肌力康复情况、盆底功能、膀胱功能及预后生活质量。结果试验组患者盆底肌力康复总有效率为97.87%(46/47)，高于对照组的72.34%(34/47，P＜0.05)；干预30 d后，2组患者的最大逼尿肌压力、最大尿流量、膀胱顺应性等指标水平均升高，且试验组膀胱功能指标高于对照组(均P＜0.05)；干预30 d后，2组患者盆底功能障碍问卷(PFDI-20)评分均降低，且试验组PFDI-20评分低于对照组(P＜0.05)；干预30 d后，2组患者生活质量综合评定量表(GQOLI-74)评分均提高，试验组GQOLI-74评分高于对照组(P＜0.05)；试验组患者干预后尿路感染、尿潴留等不良反应发生率均低于对照组(均P＜0.05)。结论间歇导尿法联合盆底肌康复训练可有效改善宫颈癌患者术后盆底及膀胱功能，促进患者术后盆底肌力恢复，提高术后生活质量，值得积极应用推广。
- 间歇导尿法 /
- 盆底功能 /
- 宫颈癌 /
- 康复锻炼 /
- 膀胱功能 /
- 生活质量
Abstract: Objective To explore the application of intermittent catheterization combined with pelvic floor muscle rehabilitation training in postoperative rehabilitation of patients with cervical cancer, analyze the influence on bladder function and quality of life of patients, and provide reference for the development of postoperative rehabilitation programs for cervical cancer. Methods A total of 94 cases of cervical cancer patients who received surgical treatment in the Second Affiliated Hospital of Wenzhou Medical University from October 2020 to October 2022 were included in the study. All patients were divided into experimental group and control group according to random number table method, with 47 cases in each group. The patients in the control group were received conventional pelvic floor rehabilitation measures after operation, and the patients in the experimental group were received intermittent catheterization combined with pelvic floor muscle rehabilitation training. The postoperative pelvic floor muscle strength recovery, pelvic floor function, bladder function and prognostic quality of life were compared between the two groups. Results The total effective rate of pelvic floor muscle strength rehabilitation in experimental group was 97.87% (46/47), which was higher than that in control group (72.34%, 34/47, P < 0.05). After 30 days of intervention, the maximum detrusor pressure, maximum urine flow, bladder compliance and other indicators were increased in both groups, and the bladder function index in experimental group was higher than that in control group (P < 0.05). After 30 days of intervention, PFDI-20 score of pelvic floor function was decreased in both groups, and PFDI-20 score of experimental group was lower than that in control group (P < 0.05). After 30 days of intervention, the GQOLI-74 score of quality of life in both groups was improved, and the GQOLI-74 score of experimental group was higher than that in control group (P < 0.05). The incidence of urinary tract infection, urinary retention in experimental group was lower than those in control group (P < 0.05). Conclusion Intermittent catheterization combined with pelvic floor muscle rehabilitation training can effectively improve the pelvic floor and bladder function of patients with cervical cancer after surgery, promote the recovery of pelvic floor muscle strength, improve the prognosis of life quality, and it is worthy of active application and promotion.
- Intermittent catheterization /
- Pelvic floor function /
- Cervical cancer /
- Rehabilitation exercise /
- Bladder function /
- Quality of life

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表 1 2组宫颈癌患者盆底肌力康复情况的比较[例(%)]

Table 1. Comparison of pelvic floor muscle strength rehabilitation of cervical cancer patients between the two groups[cases(%)]

组别	例数	显效	好转	无效	总有效
对照组	47	19(40.43)	15(31.91)	13(27.66)	34(72.34)
试验组	47	28(59.57)	18(38.30)	1(2.13)	46(97.87)
注：2组康复总有效率比较，χ²=12.086，P=0.001。

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表 2 2组宫颈癌患者干预前和干预30 d后膀胱功能指标水平的比较(x±s)

Table 2. Comparison of bladder function indexes before intervention and 30d after intervention between the two groups of cervical cancer patients(x±s)

组别	例数	最大逼尿肌压力(cmH₂O)		最大尿流量(mL/s)		膀胱顺应性(cmH₂O)
组别	例数	干预前	干预30 d后	干预前	干预30 d后	干预前	干预30 d后
对照组	47	10.02±1.35	13.52±1.71^a	7.48±1.33	9.21±1.42^a	21.35±1.09	26.44±2.26^a
试验组	47	10.12±1.19	19.48±1.97^a	7.74±1.28	14.25±1.49^a	21.39±1.25	35.86±3.45^a
t值		0.381	15.663	0.966	16.787	0.165	15.658
P值		0.704	< 0.001	0.337	< 0.001	0.869	< 0.001
注：与同组干预前比较，^aP < 0.05。1 cmH₂O=0.098 kPa。

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表 3 2组宫颈癌患者干预前和干预30 d后盆底功能PFDI-20评分的比较(x±s，分)

Table 3. Comparison of PFDI-20 scores of pelvic floor function between the two groups of cervical cancer patients before intervention and 30d after intervention(x±s, points)

组别	例数	干预前	干预30 d后
对照组	47	151.24±17.92	78.55±8.22^a
试验组	47	152.65±19.23	38.16±6.46^a
t值		0.368	26.486
P值		0.714	< 0.001
注：与同组干预前比较，^aP < 0.05。

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表 4 2组宫颈癌患者干预前和干预30 d后生活质量GQOLI-74评分的比较(x±s，分)

Table 4. Comparison of GQOLI-74 score of quality of life in patients with cervical cancer between the two groups before intervention and 30 days after intervention(x±s, points)

组别	例数	干预前	干预30 d后
对照组	47	54.42±3.71	63.46±4.14^a
试验组	47	55.08±3.22	77.34±4.35^a
t值		0.921	15.846
P值		0.359	< 0.001
注：与同组干预前比较，^aP < 0.05。

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表 5 2组干预后不良反应发生率的比较[例(%)]

Table 5. Comparison of the incidence of adverse reactions after intervention between the two groups[cases(%)]

组别	例数	尿路感染	尿潴留	尿失禁	肾积水
对照组	47	13(27.66)	5(10.64)	19(40.43)	4(8.51)
试验组	47	1(2.13)	0	3(6.38)	0
χ²值		12.086	5.281	15.192	4.178
P值		0.001	0.022	< 0.001	0.041

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